Hospice Conditions of Participation (CMS-10277)

ICR 201803-0938-001

OMB: 0938-1067

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2018-07-27
IC Document Collections
IC ID
Document
Title
Status
230612
New
230608
New
211892
Modified
211891
Modified
211890
Modified
211889
Modified
211888
Modified
211887
Modified
211886
Modified
211885
Modified
211884
Modified
211883
Modified
211882
Modified
211881
Modified
211880
Modified
195470
Modified
195469
Modified
195468
Modified
189585
Modified
189584
Modified
189583
Modified
189582
Modified
189581
Modified
189580
Modified
189579
Modified
189578
Modified
189577
Modified
189576
Modified
ICR Details
0938-1067 201803-0938-001
Historical Active 201406-0938-002
HHS/CMS
Hospice Conditions of Participation (CMS-10277)
Reinstatement without change of a previously approved collection   No
Regular
Approved with change 08/14/2018
Retrieve Notice of Action (NOA) 03/16/2018
  Inventory as of this Action Requested Previously Approved
08/31/2021 36 Months From Approved
20,992,646 0 0
3,749,351 0 0
0 0 0

The CoPs and accompanying requirements specified in the regulations are used by Federal or State surveyors as a basis for determining whether a hospice qualifies for approval or re-approval under Medicare. CMS and the healthcare industry believe that the availability to the hospice of the type of records and general content of records, which this regulation specifies, is standard medical practice, and is necessary in order to ensure the well-being and safety of patients and professional treatment accountability.

US Code: 42 USC 1395x Name of Law: Hospice Care; Hospice Program
   PL: Pub.L. 97 - 248 122 Name of Law: Tax Equity & Fiscal Responsibility Act
   PL: Pub.L. 101 - 239 6005(b) Name of Law: Omnibus Reconciliation Act of 1989
   PL: Pub.L. 105 - 33 Title IV, Chapter 4 Name of Law: BBA of 1997
   PL: Pub.L. 108 - 173 946 Name of Law: Medicare Prescription Drug, Improvement, & Modernization Act of 2003
  
US Code: 42 USC 1395x Name of Law: Hospice Care; Hospice Program

Not associated with rulemaking

  82 FR 58612 12/13/2017
83 FR 7479 02/21/2018
No

28
IC Title Form No. Form Name
Hospice Conditions of Participation 418.114 (d)
Hospice Conditions of Participation 418.114 (b)
Hospice Conditions of Participation 418.22(b)(3)
Hospice Condition of Participation (418.22(b)(4) and (b)(5)
Hospice Conditions of Participation 418.22(b)
Hospice Condtions of Participation 418.52(a)
Hospice Conditons of Participation 418.24 develop election form
Hospice Conditions of Participation 418.108(c)
Hospice Conditions of Participation 418.58 Phase 2 aggregate/data analysis
Hospice Conditions of Participation 418.58 Phase 3
Hospice Conditions of Participation 418.110(n) documentation
Hospice Conditions of Participation 418.108(c)(3)
Hospice Conditions of Participation 418.28 explain revocation form
Hospice Conditions of Participation 418.24 explain election form
Hospice Conditions of Participation 418.28 develop revocation form
Hospice Conditions of Participation 418.52(b)
Hospice Conditions of Participation 418.100(e)
Hospice Conditions of Participation 418.110(m)
Hospice Conditions of Participation 418.58 Phase 1
Hospice Condition of Participation 418.58 Phase 2 data entry
Hospice Conditions of Participation (418.52(a)(3)
Hospice Conditions of Participation 418.56(b) and (c)
Hospice Conditions of Participation 418.76(c) and (d)
Hospice Conditions of Participation 418.78(a)(c)(d) and (e)
Hospice Conditions of Participation 418.106(a) and (e)
Hospice Conditions of Participation 418.110(n) training
Hospice Conditions of Participation (418.110 (n) new hospice training program
Hospice Conditions of Participation 418.112(e)(3)

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 20,992,646 0 0 18,128 1,690,029 19,284,489
Annual Time Burden (Hours) 3,749,351 0 0 1,511 505,560 3,242,280
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
The total annual hourly burden for the information collection requirements is estimated to be 3,749,351 hours. The 507,071 hours hour increase is due to two main factors. First, the number of Medicare-certified hospices has increased by 576 hospices, from 3,897 to 4,473. Second, the number of patients receiving hospice services has increased 51,608 patients, from 1, 535,919 to 1,587,527 (1,428,775 Medicare Beneficiaries and 158,752 non-Medicare Beneficiaries).

$0
No
    No
    No
Yes
No
No
Uncollected
Denise King 410 786-1013 Denise.King@cms.hhs.gov

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/16/2018


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